Hospitals are finding themselves short of a wide range of medications more frequently and for longer. Delaying treatment is becoming less of a rarity at US hospitals today. Emergency doctors fear that soon lives will be lost when they cannot get their hands on some crucial drugs.
There are times when the supply and demand of certain drugs go in wrong directions and there is a shortage, and sometimes total unavailability. What concerns a growing number of health care professionals is that the problem is growing rapidly. 211 drugs were listed as in short supply in 2010, three times more than in 2006.
The University of Utah’s Drug Information Service informs that during the first quarter of this year there have been 89 drug shortages. Just on the 25th and 26th of May, 2011, the American Society of Health-System Pharmacists reported new shortages of the following medications – Ciprofloxacin Immediate-Release tablets, Magnesium sulfate injection, Paclitaxel injection, Aminocrapoix acid injection, Prochlorperazine edisylate injection, Triamterene and Hydrochlorothiazide capsules and tablets, and Vasopressin injection.
Hospital pharmacists and medical personnel inform that some shortages can go on for several months. Many of these medications have no ideal substitute. Hospitals in several other countries are reporting similar problems.
In some cases it might be a chemotherapy medication for cancer treatment. Local media in Florida reported a case of a 14-year-old girl with leukemia whose chemotherapy sessions had to be postponed because of a long-lasting nationwide cytarabine shortage.
Pharmacists and drugmakers cite the following reasons for drug shortages:
- Product recalls
- Contaminated vials
- Difficulties in importing certain raw materials
- Demand fluctuations
- Production plants being upgraded (and closed while the upgrade is being carried out)
The more expensive the drug, the less likely there is a shortage of it, experts have noticed. Cheaper, older generic products have smaller profit margins and fewer pharmaceutical companies want to be involved in making them.
Shortages include drugs for a wide range of therapeutic areas, including premature babies, septic shock, intravenous feeding, fertility treatment, ADHD, emergency room cardiac arrest, cystic fibrosis, and cancer.
According to the Institute for Safe Medication Practices, two patients died last year because their substitute painkiller dosage was wrong – at the time there was a shortage of morphine. However, nobody is monitoring patient harm at a national level.
Approximately 40% of thyroid cancer patients will not have access to a drug – Thyrogen – until July or August this year. Thyrogen helps patients who have had their thyroid gland surgically removed avoid the considerable side effects of hormone withdrawal. For those who need this medication, there is no comparable available alternative drug. The European Journal of Endocrinology reports that patients on Thyrogen had 8.1 fewer absent days from work compared to those on withdrawal. Most endocrinologists prescribe Thyrogen before treatment.
Worldwide supplies of Thyrogen will be unreliable until about July, says the Genzyme Corporation, makers of the drug.
Recent shortages of ADHD (attention deficit hyperactive disorder) drugs have sent patients or their parents going from pharmacy-to-pharmacy desperately seeking medications such as Adderall and its generic equivalents. According to IMS Health, the shortage affected a combined 24.2 million prescriptions’ worth of drugs in 2010.
Franciscan St. Elizabeth Health Clinical Manager, pharmacist Carol Miller said in a recent interview:
“As a pharmacist working for 20-some years, I’ve seen shortages, but nothing with the numbers of drugs out there that are short at this time.”
Miller believes the recent global economic crisis has affected drug supplies. When the economy is tight pharmaceutical companies tend to drop production of the least money making drugs. If there are generic products available, some drug companies simply stop making their brand products.
With current federal regulations the way they are, it is difficult for generic makers to respond rapidly.
Written by Christian Nordqvist